Saturday, November 9, 2013

The regulations, which specifically put into effect the 2008 Mental
Health Parity and Addiction Equity Act, would affect most Americans with
insurance — roughly 85 percent of the population — whether their
policies are from employer plans, other group plans, or coverage
purchased in the market for individual plans.

The final parity rules do not apply to health plans that manage care for millions of low-income people on Medicaid.
However, the administration has previously issued guidance to state
health officials saying that such plans should meet the parity
requirements of the 2008 law.

This finally evens standards between the traditionally relatively generous coverage in American insurance plans for physical ills and the cut-rate coverage for mental health care. Specifically, it evens standards for co-pays, deductibles, co-insurance, number of visits and network coverage; including the residential treatment and outpatient programs often employed for treating drug addiction.

This rule has some personal meaning for me. This specific issue was one of the final sticking points in contract negotiations for my grad local union at the University of Michigan in 2008 -- it was like pulling teeth to expand the absurdly low limits on out-patient visits to manage mental health conditions. Grad students tend to be physically healthy, but we have very high rates of depression and anxiety disorders.

As the Times' story notes, that status-quo changed later that year with the passage of the Mental Health Parity Act. Oddly enough, this passed as a rider on the TARP package; who knew that bailing out the banks would be good for Americans' mental health?

The final rule announced yesterday supersedes an interim rule put into place in 2010 and completes a five-year journey from the act's passage.

The rule is important in and of itself, but its importance multiplies when combined with the coming implementation of the Affordable Care Act. For the first time millions of people currently without insurance will get insurance. And now that insurance will actually guarantee good access to mental health care. The implications of the Medicaid expansion for substance-abuse treatment and reducing violence alone are astonishing and welcome. The implications for reducing the stigma around mental illness are also significant as well.

Of course, the fight isn't over and the rule mandating parity with mental health won't mean diddly for those below the poverty line in states refusing to expand Medicaid -- which makes it all the more imperative for Medicaid expansion to become the No. 1 policy priority for progressives in the 2014 and 2016 state-level elections